OCD Symptoms: Intrusive Thoughts, Compulsions and When to Get Support
OCD is one of those mental health conditions that is often spoken about casually, but not always understood properly. People might say they are “a bit OCD” because they like things tidy, organised or done in a certain way but obsessive compulsive disorder is not the same as liking a clean kitchen, colour-coding your wardrobe or wanting your desk to look neat. For many people, OCD can feel exhausting, frightening and hard to explain as it can involve unwanted thoughts, repeated checking, reassurance-seeking, rituals, avoidance, or mental reviewing that other people may not even notice.
That is one of the reasons people often delay asking for help.
They may worry they will not be understood, they may feel embarrassed or they may not realise that what they are experiencing could be OCD.
What are OCD symptoms?
OCD symptoms usually involve two connected parts: obsessions and compulsions.
- Obsessions are unwanted thoughts, images, doubts or urges that keep coming back and cause distress.
- Compulsions are the things a person does to try to reduce the anxiety, doubt or discomfort caused by those obsessions.
Sometimes compulsions are visible, such as checking a lock several times or washing hands repeatedly, but sometimes they happen inside someone’s head, which can make OCD much harder to spot. A person might look completely calm from the outside, while privately feeling trapped in a loop of fear, checking, guilt or uncertainty.
OCD is not just about being clean or tidy
This is one of the biggest misunderstandings around OCD.
Some people with OCD do have fears around contamination, germs or cleanliness but OCD can show up in many different ways. It may involve fears about harm, responsibility, morality, relationships, health, religion, sexuality, mistakes, memories, or whether something feels “just right”. For example, someone may repeatedly check whether they turned the oven off, not because they are forgetful, but because they feel overwhelmed by the fear that something terrible could happen if they do not check again. Someone else may ask for reassurance over and over, not because they are being difficult, but because their mind keeps demanding certainty.
That is one of the hardest parts of OCD – it often feeds on doubt.
Intrusive thoughts and OCD
Intrusive thoughts are unwanted thoughts, images or urges that seem to arrive suddenly and can feel upsetting, confusing or completely out of character. Many people experience intrusive thoughts from time to time. Having an intrusive thought does not mean someone wants it to happen, agrees with it, or is a bad person. With OCD, the problem is often not the thought itself, but the meaning a person attaches to it. A thought may feel so alarming that the person starts trying to work out why they had it, what it means, whether it says something about them, or how they can be completely sure they would never act on it.
This can lead to a cycle of:
- Unwanted thought
- Fear or disgust
- Checking or reassurance-seeking
- Temporary relief
- The thought coming back again
The relief does not usually last, which is why OCD can become so draining.
Common OCD compulsions people may not recognise
When people think about compulsions, they often picture handwashing or checking doors. Those can absolutely be part of OCD, but compulsions can also be much less obvious.
Common compulsions can include:
- Checking locks, switches, appliances or messages
- Washing, cleaning or avoiding things that feel contaminated
- Counting, repeating or doing things in a particular order
- Asking for reassurance from other people
- Replaying conversations or events in your head
- Mentally checking how you feel about something
- Researching symptoms repeatedly online
- Avoiding people, places or situations that trigger distress
- Seeking certainty before making everyday decisions
- Confessing thoughts or asking whether you have done something wrong
Some compulsions are private, a person may spend hours reviewing something mentally, but nobody around them would know.
That does not make it less real.
What is Pure O OCD?
You may have heard the term “Pure O” OCD. It is often used to describe OCD where the obsessions are more obvious than the compulsions. People sometimes use it when their OCD mainly involves intrusive thoughts, mental checking, rumination or reassurance-seeking rather than visible rituals. The name can be a little misleading, because compulsions are usually still there. They may just be happening internally, for example, someone may repeatedly analyse a thought, test their reaction to it, seek reassurance online, avoid certain situations, or mentally review past events. So while it may not look like the more stereotypical version of OCD, it can still be extremely distressing and time-consuming.
Signs OCD may be affecting daily life
It may be worth seeking support if OCD symptoms are starting to interfere with your life, relationships, work, education or emotional wellbeing.
Some signs include:
- Spending a lot of time stuck in thoughts, rituals or checking
- Avoiding situations because they trigger anxiety or doubt
- Needing repeated reassurance but never feeling settled for long
- Feeling ashamed, frightened or distressed by your thoughts
- Struggling to sleep because your mind will not switch off
- Feeling responsible for preventing something bad from happening
- Finding it hard to focus because your mind keeps pulling you back into the same worry
- Feeling that everyday tasks take far longer than they should
It is also common for people to delay asking for help because they think they should be able to “just stop” but OCD is not a lack of willpower, it is not attention-seeking and it is not something someone should have to manage alone.
Can OCD be linked with anxiety?
OCD and anxiety are closely connected.
Many compulsions are carried out to try to reduce anxiety, fear, doubt or discomfort. The difficult part is that compulsions may bring short-term relief, but they can keep the cycle going long-term. This is why simply telling someone with OCD to “stop worrying” or “just don’t check” is rarely helpful. The person may already know their fear feels excessive. They may already feel frustrated with themselves. But the need to feel certain can be incredibly powerful.
Support can help people understand the cycle and begin to respond to intrusive thoughts and compulsions differently.
What support is available for OCD?
Support for OCD may include talking therapy, cognitive behavioural therapy, and in some cases psychiatric assessment or medication advice. CBT is often used to help people understand how thoughts, feelings and behaviours are connected. For OCD, this may include exposure and response prevention, often called ERP. ERP involves gradually facing feared thoughts, situations or triggers while learning not to respond with the usual compulsion. This is usually done carefully and at a pace that feels manageable, with professional support. The aim is not to force someone into distress, it is to help reduce the power OCD has over everyday life. Some people may also benefit from speaking with a psychiatrist, particularly if symptoms are severe, complex, or linked with other mental health difficulties.
When should someone ask for help?
There is no rule that says you have to wait until things feel unbearable before asking for support. It may be enough that OCD symptoms are taking up more space than you want them to or that you feel stuck in the same cycle and do not know how to step out of it. Many people make first contact before they fully understand what is happening and that is okay. You do not need to arrive with the perfect explanation, you do not need to know whether you need therapy, psychiatry, counselling or something else. A first conversation can simply be a starting point.
You might say:
“I think I may be struggling with OCD symptoms.”
Or:
“I keep having intrusive thoughts and I do not know what to do with them.”
Or even:
“I am not sure what I need, but I think I need to speak to someone.”
That is enough.
Getting support for OCD symptoms
OCD can be deeply misunderstood, which can make it feel even harder to talk about, but support is available, and you do not have to explain everything perfectly before reaching out. At The Therapy Company, our team supports adults, children, young people and families with a range of mental health difficulties. This includes support through therapy, counselling and private psychiatry, with appointments available from our Preston clinic and online.
If OCD symptoms, intrusive thoughts, compulsions or repeated reassurance-seeking are affecting your day-to-day life, you can contact the team to discuss what support may be suitable.
Not sure where to start?
If you are struggling with intrusive thoughts, compulsions, checking, reassurance-seeking or anxiety around OCD symptoms, you do not need to have everything worked out before getting in touch. The Therapy Company offers mental health support from our Preston clinic, with online appointments also available.